Thoughts, tips, ideas and guidelines.



Growing up in Abilene, Texas was not as thrilling as one might think.

I was a girl with a streak of tomboy. See, I loved sports. While my older sisters played softball, volleyball, and basketball, I loved watching them play.

I carefully learned the rules and dreamed of being the one who hit the walk off home run in softball or served the last ace to win the volleyball match.

Unfortunately, I was born with an intense fear of being hit by the ball — any ball.

I was a tall kid, a bit lanky, and did not have a competitor’s body, skills, or confidence. Although I loved the idea of participating in sports, my awkward body and fearful brain made it nearly impossible for me to excel in any sport.

I tried my best to rise to the challenge of playing softball, volleyball, basketball and other sports. But every time, I feared any ball coming my way would hit me. I’d throw up my hands, wince, close my eyes, and ultimately not catch the ball. Quickly, the other teams noticed that I was the weak link in the chain and purposely hit the balls in my direction. Instead of being a team hero, I was the one that no one wanted on the team.

When my father and an older sister saw my frustration, they started practicing catch with me. With their kindness and care, I realized that I could control my fear of getting hit by the ball — by catching it!

If I caught the ball every time, it would not be able to hit me. Amazing!

I was given the keys to the kingdom.

Now that I was armed with logic and calculation of how to win, my love for all sports flourished.

Later, another older sister taught me to play racquetball. Though I wasn’t very good, I loved the sport because it’s a great way to release your frustrations. You can hit the ball as hard as you want and never have to chase it out of bounds.

During the first three years of moving to San Antonio for medical school, I didn’t even touch a racket. In my fourth year, I suddenly found myself with some free time. I found a racquetball coach who taught me the skills and finesse of the game.

With excellent coaching and a lot of hard work and practice, I improved and began playing in tournaments. Racquetball players are grouped in tournaments by their skill level — Novice, D, C, B, A, to Open-level players.

Over several years, I rose to rank 4th in the Texas Women’s Open.

And that’s not all. I ultimately met my husband through racquetball. We’ve been married almost 15 years.

I own a shirt that says, “There’s nothing that a good day of racquetball can’t cure.”

This has remained true for me for many years.

Key Point: When life, work, or anything else gets stressful, hectic, or nearly unbearable, it is important to complete this sentence and live accordingly: “There’s nothing that a good day of ________ can’t cure.”



Thank you for joining us for this week’s blog to see how my Mission of Infusing Hope can take hold…

As a lung doctor who specializes in COPD, I came into the picture during her second hospitalization.

I took this opportunity to both teach Ms. B. how to manage her condition on a daily basis. I also decided to model behaviors and techniques for our team of physicians in training. I wanted to show how to motivate a patient like Ms. B to become a member of the healthcare team.

I started her on the appropriate inhalers and, after detailed education, she showed us that she knew how and when to take them. I also told her that she needed supplemental oxygen. Ms. B expressed grief, anger, and frustration about being tethered to an oxygen tank 24/7.

She said that she didn’t know if she could quit smoking forever because she’d tried and failed many times before. So, I used motivational interviewing and other techniques to help her see that she could stop smoking. How? With Ms. B having the right attitude and a lot of help from our whole team.

I next saw her in follow-up clinic about two months after being released from the hospital. Ms. B introduced me to her new friend, Joe. She said that she and Joe went everywhere together — the shopping mall and grocery store, Spurs games, and even to Zumba classes.

Since I only saw Ms. B in the examination room, I asked her if Joe stepped out to go to the bathroom. She laughed! She said, “no” and then excitedly pulled out her green oxygen tank with fully decorated black cover.

She said, “This is Joe!”

She then shared that she originally felt like a casualty in the war against COPD and was not going to be punished by wearing oxygen tubing for the rest of her life.

However, after our conversations in the hospital, Ms. B decided to see things differently. So, she added her oxygen tank to our healthcare team, named him, and saw him as a friend rather than the enemy.

Yes! As I experienced with Mr. P (see the blog: THE STORY OF MR. P WITH UNCONTROLLED COPD), my Mission of Infusing Hope made a major improvement in the life of Ms. B.

I’m pleased to report that it’s now been three years since Ms. B was hospitalized and she is doing great!

Along with Joe, she’s remained an active member of her healthcare team and no longer sits on the sidelines as a passive observer. Actually, she’s become a master at advocating for herself. She takes the bull by the horns and is now leading a full and active life.



When you’re told that you have COPD (Chronic Obstructive Pulmonary Disease), this may cause a variety of reactions:

  • Ignore or deny the news.
  • Feel down or depressed.
  • Be angry.
  • Face the news head on and learn to advocate for yourself.
  • Feel it’s your fault for having started smoking (if you ever had smoked).

So, I’m the first to say to you: It is not your fault. Smoking is very addictive.

People who continue to smoke are not weak. It is not a character flaw. Although stopping smoking without restarting is difficult, it is possible.

Now, I’d like you to imagine a possible scenario after being diagnosed with COPD:

  • Time passes after your diagnosis.
  • You’re hesitant to do what your healthcare provider requests in order to improve your health and manage your COPD.
  • Perhaps you don’t even understand very well what to do.
  • Your health declines.
  • You find yourself gasping for breath, exhausted, and coughing.
  • You’re completely uncomfortable.
  • Your situation sends you to your local hospital’s ER.

Things look grim, right?

Let’s continue with this scenario:

  • You’re then hospitalized and absolutely dread what may come next.
  • You believe your life is changed forever for the worse
  • You feel that it’s all your fault!

You’re thinking, “If only I hadn’t started smoking when I was a teenager,” right?

I encountered just this person in 2013. Let me tell you about Ms. B:

She was a strong, independent woman who had served our country for 19 years in the Navy and the Reserves. She’d been diagnosed with COPD, but in her own words she “was very casual” about her diagnosis.

You see, smoking had been her solace and her friend. But now smoking was her enemy.

Ms. B’s COPD had landed her in the hospital twice that year. Once, she could barely muster enough energy and breath to even call 911 to take her to the hospital.

Though she was prescribed a couple of inhalers, she did not know how or when to take them properly. She felt intimidated and was afraid to ask for guidance.

Ms. B just wanted it (her COPD) to go away and she felt ashamed that she couldn’t quit smoking.

She and her healthcare professionals were not working as a team or even acting that way. Frustrated, they seemed to be speaking different languages without an interpreter.

Please read next week’s blog to discover if I can help Ms. B…

I’m Only Here Because My Trainer Told Me I Should Come Part 2

Thank you for joining us for this week’s blog to see if and how I stretch the limits of my comfort zone…

To say the least, it was a difficult session for both the therapist and me. Though I tried so hard to relax and not be tense, it was a losing battle.

The therapist made idle conversation to help me relax more while he worked on my tense body. But as soon as he relaxed one area of my body, it would tighten up when he moved on to the next area.

The session seemed so long. Although I was there to relax, I became increasingly stressed.

Finally, the therapist said what I was longing to hear: “Okay, I’m finishing and will step out while you get dressed. Be careful getting up. You may be dizzy. I’ll meet you at the front desk.”

I quickly dressed and went to the front desk. There, the therapist offered me water and asked, “How do you feel?”

I exclaimed, “Wow, I can actually move my neck!”

As I bent my neck from side to side and front to back, I was amazed. Until that moment, I hadn’t realized how little I could move my neck for the last several years.

Then the therapist’s face got the strangest look. He said, “That’s what happens when you get a massage.”

After a long day of teaching the following day, I received a call.

“Hello, this is Jacob, your therapist from yesterday. I’m calling to check up on you. How did you do after yesterday’s session?”

I was impressed that Jacob cared enough to follow up with me.

Little did I know then that he’d told his secretary to not enter me into his client list because he had already written me off as never returning.

I shared that I slept well for the first time in months and was still able to move my neck.

By habit, Jacob asked, “Would you like to schedule another session?” I replied, “When can you see me next?”

I returned three days later and again the next week. And I’ve returned for regular massage therapy sessions since then.

So, I not only found a therapist, I developed a new friendship. Actually, I gained an adopted family member in the process.



I walked into the office and checked in with the front desk secretary for my 3:00 pm appointment. She told me to sit down, fill out the required form, and she’d call my name shortly.

So, I waited – with apprehension and discomfort.

When my name was called and I was led into a softly lit room. I thought how the room was designed to relax most people because it was decorated with many feng-shui principles.

The room had well-positioned, round mirrors of various sizes in an interesting pattern on the wall. There was a tall, triangular chest of drawers in the corner and a post-modern chrome and leather chair. The opposite wall had different-sized Buddha heads sitting on small black cubic shelves, each perfectly sized to fit the head. Music played softly in the background.

I tried hard to avoid looking at the massage table with sheets and a face cradle. Despite the feng-shui decor, my stress level increased when I remembered, “Yes, I was really going to have my first massage.”

The therapist asked, “So what brings you in?”

I replied, “I’m only here because my trainer told me I should come.”

He then asked a battery of questions:

  • Do you have any pain?
  • Where do you carry your stress?
  • When was your last session?
  • What type of pressure do you like?

I explained that I’d never had a massage, I was a private person, and – again — I was only there because my trainer told me to have a massage session.

I also confessed that I did not like to be touched.

Then the therapist asked, ”You are aware that a massage involves being touched, right?”

I replied, “Yes, of course, but I just want you to know that I’m not comfortable with it.”

With a bit of trepidation in his voice, the therapist instructed me to undress to my comfort level and lie face down and cover myself with the sheet on the table. He would return when I was ready to start.

As he closed the door, I muttered under my breath, “Undress to my comfort level? Even removing my shoes when I’m fully clothed stretches the limits of my comfort zone.”

Please read next week’s blog to find out how I, a doctor, deal with this therapy situation…

MABA – MAINTAIN BALANCE | Sandra’s “Lessons” Learned & Shared Series, Part 4


The fourth and final lesson that I shared in my June 2014 convocation speech is about maintaining balance between medicine and life.

In a survey published in a 2012 issue of JAMA Internal Medicine, nearly one half of physicians who responded reported at least one symptom of burnout. Less than half of the physicians reported satisfaction with work-life balance.

Early in my career, I would not have been able to personally talk about finding a balance between medicine and life. That’s because I, too, suffered from burnout.

But now I can talk about the work-life balance for physicians and other healthcare professionals.

How did I come to this point? When I decided that the best way for me to take care of my patients was to start taking better care of myself.

Where did I begin? I started playing racquetball again!

Next, I discovered massage therapy and other relaxation techniques. I actually scheduled more time for my family and friends.

Then I decided to try something that I wanted to do since my childhood — Gymnastics!

So, at the age of 42 years old, I found a local gymnastics coach and began working on handstands, cartwheels, and round-offs. Soon my coach introduced me to the trampoline.

I had always played a variety of sports, but I had never had tried a flip, not even into a swimming pool.

Over the last five years, I have mastered a floating front tuck. That’s a front flip with bent knees. I’ve also learned to perform a back tuck. That’s a backward flip on the trampoline without the support of a belt!

Along with these athletic endeavors, I also maintain balance in my life by doing something as frivolous as playing games at Dave & Buster’s a few times per month.

I am much happier overall.

I’m excited to go to work and care for my patients. I’m excited to teach a variety of interprofessional students at all levels. And I’m excited to conduct research and participate in various other activities in medicine.

Key Point: See the scale in the middle of the marble coaster. This scale symbolizes my fourth and final lesson that I share when teaching each healthcare professional. This lesson: Make a concerted effort to find and then maintain balance between medicine and life.

Congratulations. You now know the meaning behind MABA – MAINTAIN BALANCE.

 So, take a breath. You don’t have to remember all four lessons right now — because we’ll have a quick review next week.

Yes, I not only know how to pace my patients and students, but you, our blog readers!